FIFO work takes toll on mental health

THE mental health of Australia’s FIFO (fly-in/fly-out) workers hit the news in March after it emerged that a Darwin gas plant had clocked up its 14th suicide on site since construction began in 2012. Just hours after a man had killed himself at the Inpex Ichthy plant, the subcontractor involved sent a letter to the man’s colleagues telling them that they were expected at work the next day, and that any time off would require a medical certificate.

That heartless response predictably sparked outrage, leading to union claims of a toxic work culture and calls for an end to practices that were “fraught with danger when it comes to mental health”.

The situation at the Darwin plant may be particularly egregious, but a new study published in the MJA shows that psychological distress in remote mining and construction workers across the country is markedly higher than in the general population.

The study, led by Associate Professor Jennifer Bowers of the Adelaide-based not-for-profit organisation Rural and Remote Mental Health, involved over 1100 employees at ten mining sites in South Australia and Western Australia. Participants anonymously completed a psychological distress survey and self-reported their mental health status concerning a number of issues, including work, lifestyle and family life factors.

Close to 30% of respondents reported high or very high levels of distress – almost three times greater than the rate of 10.8% in the general population. The most frequently cited triggers for stress were missing special events, relationship problems, financial stress, shift rosters and social isolation.

Dr Bowers says that the high prevalence of psychological distress in FIFO work is a complex issue, but the fact that the workplace is overwhelmingly male plays a role.

“It’s to do with the macho environment and not being prepared or willing to talk about issues as women may be more able to do,” Dr Bowers told MJA InSight in an exclusive podcast. “But another compelling factor is they do not want to risk their job. They don’t want to say they have a problem, because they may have high levels of financial commitment.”

Another issue is age, Dr Bowers says. The study found that those at the highest risk of psychological distress were in the lower, 25–34 years, category.

“That’s the age when one is most likely to have a young family. The younger workers are also not so good at planning before they go away. If internet access is not reliable on-site, then it’s hard to pay bills and communicate. There are a range of limitations that need planning and they need to manage this to reduce their stress.”

Kristy-Lee Alfrey, a medical researcher at Central Queensland University who has co-authored an article on the mental health of FIFO workers, agrees that stigma around mental health issues in a predominantly male community is a key driver to psychological distress.

“These men are saying to themselves, ‘I can’t be weak, I can’t be having these emotions’. Or they accept the emotions, but they don’t want to talk about them for fear of being judged or getting a black mark on their name in the industry.”

She says that even when there is adequate mental health support on-site, workers are afraid to use it in case their employer finds out.

“Some people go into this work because they love it, but others see the money and the chance to set themselves up financially. And once they start earning more, they can overcommit, or just become increasingly comfortable in that income bracket. Giving up the FIFO work would mean a massive drop in pay that they’re not ready or can’t afford to accept. So, they end up feeling trapped.”

Ms Alfrey says another issue is a misconception over who should be accessing mental health support services.

“A lot of people look at mental health support as something you should only use if you’re clinically depressed or have another clinical condition. There needs to be more emphasis on simply getting some support for your general wellbeing and managing the unique lifestyle that FIFO workers have.”

She says that mining and construction companies could also look at offering support that goes beyond the conventional mental health services. That could be getting financial planners or life coaches to visit sites to give consultations to those who are finding things difficult.

Dr Bowers says that the focus shouldn’t just be on the employees, and that the attitudes of employers have to change too.

“Change needs to come from the top,” she says.

To find a doctor, or a job, to use GP Desktop and Doctors Health, book and track your CPD, and buy textbooks and guidelines, visit doctorportal.